GRANDPARENTS’ PERSPECTIVES ON A MULTIGENERATIONAL DIGITAL HEALTH PHYSICAL ACTIVITY INTERVENTION

Studies examining associations among grandparents’ involvement and grandchildren’s lifestyle behaviors have been largely mixed or negative highlighting the need for interventions that help grandparents promote grandchildren’s healthy behaviors. The current study explored older adults’ interest in participating in a digital intervention with their grandchildren. As part of the intervention, grandparents and grandchildren would engage in weekly walks and use a mobile application to track their steps, photos and conversations. Twelve grandparents (63±6.5yrs; 75% female; 50% Hispanic) participated in qualitative interviews. Researchers asked open-ended questions to assess grandparents’ relationships with their grandchildren, motivation to participate, and feedback on prototypes. A 10-item systems usability questionnaire was also administered. Three researchers independently analyzed interview transcripts using a rapid assessment approach and reached consensus on key themes. Grandparents described having positive relationships with their grandchildren and used texts to schedule time with them; family dynamics (conflicts, divorce) influenced the amount of time they spent together. Grandparents’ motivation for participating in the intervention included the opportunity to enhance their relationship with their grandchild and improve their own health. Grandparents noted weekly walks would feasibly occur on the weekends given their grandchildren’s competing activities. They were receptive to proposed weekly session topics (e.g., sports/hobbies, ancestry, humor) and suggested other topics to discuss during weekly walks, such as faith/religion, morality, safety, and nutrition. They strongly agreed or agreed that they would use the prototypes frequently and found them easy to use (83% and 92%, respectively). Results from this study will inform the next iteration of intervention prototypes.

Is DCIS Overrated?

Ductal carcinoma in situ (DCIS), the noninvasive form of breast cancer (BC), comprises just over 20% of breast cancer cases diagnosed each year in the USA. Most patients are treated with local excision of the disease followed by whole breast radiation therapy. Total mastectomy is not an uncommon approach, and total mastectomy with a contralateral risk-reducing mastectomy has been on the rise in the past decade. In estrogen receptor-positive disease, patients are often offered endocrine ablative therapy with a selective estrogen receptor modulator or an aromatase inhibitor as both treatment and prevention. Local regional treatment options have no impact upon ultimate overall survival. Long-term survival rates are higher in patients with DCIS than with any other form of the disease. Are these strikingly high success rates a testament to effective treatment strategies or is there a significant subset of DCIS that was unlikely to ever progress to invasive ductal carcinoma? DCIS was not seen in the US prior to the advent of screening mammography. When compared to other countries, the USA has the highest utilization of screening mammography and the incidence rate of DCIS. Other lines of evidence include autopsy series examining the breast tissue of women who died of other causes, missed-diagnosis series and current retrospective reviews of DCIS, all align in support of the concept of DCIS as indolent in the majority of cases [3-14]. The evidence suggests that both patient and physician misconceptions about DCIS have led to overdiagnosis and over-treatment of DCIS. Recently, a gene expression profiling tool (12 gene assay, Oncotype DCIS) has emerged that shows considerable promise in predicting class in DCIS patients.